| Pasadera Green Valley Site | |
|
1260 S. Campbell Rd. Building 2 Green Valley AZ 85614-0503 | |
| (520) 407-5400 | |
| (520) 407-5990 |
| Full Name | Pasadera Green Valley Site |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1260 S. Campbell Rd., Green Valley, Arizona |
| Authorized Official Name and Position | Stephanie Oliver (CHIEF QUALITY MANAGEMENT OFFICER) |
| Authorized Official Contact | 5206283400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pasadera Green Valley Site 2700 S 8th Ave Tucson AZ 85713-4730 Ph: (520) 618-8622 | Pasadera Green Valley Site 1260 S. Campbell Rd. Building 2 Green Valley AZ 85614-0503 Ph: (520) 407-5400 |
| NPI Number | 1295157972 |
|---|---|
| Provider Enumeration Date | 01/14/2014 |
| Last Update Date | 08/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295157972 | NPI | - | NPPES |
| OTC6176 | Other | AZ | STATE LICENSE |
| 882111 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC6176 (Arizona) | Primary |
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